Abstract: Objective To investigate the association between serum high-molecular weight adiponectin(HMWA),homeostatic model assessment insulin resistance index (HOMA-IR)and their ratio(A/H)and liver fibrosis in patients with newly diagnosed type 2 diabetes mellitus(T2DM)and nonalcoholic fatty liver disease(NAFLD). Methods The clinical data of 279 newly diagnosed T2DM patients with NAFLD enrolled in our hospital from May 2020 to May 2021 were retrospectively analyzed for their status of liver fibrosis.Univariate analysis and multivariate logistic regression analysis was applied to explore the independent influence factors of liver fibrosis,and to determine the predictive value of HMWA, HOMA-IR and A/H ratio for liver fibrosis. Results The prevalence of liver fibrosis in newly diagnosed T2DM patients with NAFLD was 15.77%(44/279).The serum levels of HMWA,HOMA-IR and A/H ratio of patients with liver fibrosis were 1.20 (0.91,1.78) mg/L,3.41 (2.57,5.70) and 0.33 (0.18,0.62),respectively.The serum levels of HMWA,HOMA-IR and A/H ratio of patients with non-liver fibrosis were 2.74 (1.57,3.84) mg/L,2.18 (1.61,3.12) and 1.21 (0.55,2.16) respectively. There were significant differences in the serum levels of HMWA,HOMA-IR and A/H ratio between the two groups(P<0.05).In addition to age and waist circumference,HMWA,HOMA-IR and A/H ratio were also independent predictive factor associated with liver fibrosis(P<0.05),and had a certain predictive value for liver fibrosis. The area under the curve of A/H was significantly larger than those of HMWA and HOMA-IR(Z=2.768,P=0.006;Z=2.491,P=0.013). The optimal cutoff value of the A/H ratio was 0.52,which displayed a sensitivity of 75.00% and a specificity of 78.72% for the prediction of liver fibrosis in newly diagnosed T2DM patients with NAFLD. Conclusion HMWA,HOMA-I and A/H are independently associated with the risk of liver fibrosis in newly diagnosed T2DM patients with NAFLD,and have certain predictive value. A/H has the best predictive efficacy.

Key words: Type 2 diabetes mellitus, Nonalcoholic fatty liver disease, High-molecular weight adiponectin, Liver fibrosis, Homeostatic model assessment insulin resistance index, Ratio, Predictive value